Writing for the JTA, Debra Nussbaum Cohen recaps the circumcision controversy generated by metzitza b'peh, the oral-to-genital sucking of the open circumcision wound done by many haredim. The article is good, clear summary of events, and it has some extras that make it really stand out. The first is a quote from Rabbi Dr. Moshe Tendler of Yeshiva University:
"I'm convinced that many children have been infected and not diagnosed, and years later they are in special education in the schools and no one knows why," Tendler said.
On the other side, Rabbi David Niederman of the Satmar-controlled Central Rabbinical Congress tells a whopper and gets away unchallenged:
"There have been seven cases, allegedly over a span of 15 years," he said. "In Williamsburg alone we have close to 57,000 people. The overwhelming majority is very young, so you're talking about 120,000 brises of metzitzah b'peh."
Agudath Israel estimates 2000 MBP circumcisions were done in the city last year. Less than 1/2 were done in Williamsburg. If 1000 MBP's were done in Williamsburg every year for the past 15 years, then 15,000 MBPs were performed. Surely the number is much less than this, in part due to the smaller population in earlier years.
Another way to look at is as follows. 57,000 people. 1/3 are too old or are infertile. 1/3 are too young or single. 1/3 married and of the correct age. So, we have 19,000 potential people. 1/2 are men. That leaves us with 9,500. Women give birth on average about every three years (some more, some less). So 9,500 divided by 3 = 3167 births per year. 1/2 are baby girls. That leaves 1584 boys to have MBP. But some of these births take place in the Catskills, London, etc. , so you end up with about 1400 MBPs done in Williamsburg – and that is if Rabbi Niederman's population figure is not inflated. Again, not factoring in smaller populations each year we go back, we end up with 21,000 MBPs over 15 years, 1/6 of the figure Rabbi Niederman claims.
Why is this exaggeration important? Because of what Rabbi Niederman said immediately after. The quote, now in context:
"There have been seven cases, allegedly over a span of 15 years," he said. "In Williamsburg alone we have close to 57,000 people. The overwhelming majority is very young, so you're talking about 120,000 brises of metzitzah b'peh. You tell me, is it safer to give a flu shot or to do metzitzah b'peh?"
Actually, the risk of serious injury or death from a flu shot is far less than from MBP, which by the most charitable statistic for Rabbi Niederman carries a 1 in 3000 chance of serious illness, maiming or death.
But none of this matters to the haredim:
"We are convinced that it's not dangerous," [Rabbi Niederman] said.
Not surprising from a community led by a man who cannot do simple math.
Controversy rages in New York over circumcision practice
By Debra Nussbaum CohenNEW YORK (JTA) - In the face of a religious court's failure to conclude its investigation of a mohel who transmitted herpes to three babies, New York City's health commissioner recently issued an unprecedented public warning that a controversial circumcision procedure is endangering the lives of Jewish infants.
"There exists no reasonable doubt that 'metzitzah b'peh' can and has caused neonatal herpes infection," Dr. Thomas Frieden wrote in December in "An Open Letter to the Jewish Community" about a procedure routinely practiced by mohels in some "haredi" - or ultra-Orthodox - sectors of the Jewish community. "The Health Department recommends that infants being circumcised not undergo metzitzah b'peh."
The letter - the Health Department's first official warning against the procedure - follows an apparent breakdown in an agreement the department had with a Jewish religious court in Williamsburg, Brooklyn.
In September, the city withdrew a lawsuit against a mohel the department concluded had transmitted the disease to three babies on whom he had performed the procedure, including one who died as a result and one who suffered brain damage. It also withdrew a court order barring him from continuing to use the technique.
In exchange, Rabbi Yitzchok Fischer agreed temporarily to stop performing metzitzah b'peh voluntarily. And a Jewish religious court took up the case for final resolution. But according to Frieden, the religious court, or Beit Din, failed to meet the Dec. 1 deadline.
"They've since communicated to us that it's a complicated situation and they're not sure when they can come back," Frieden said. "So rather than let that continue indefinitely, we felt it was important to make clear to the public our own conclusion and position."
Rabbi David Niederman, liaison for the Williamsburg Beit Din, said he was "shocked" at Frieden's reaction to the delay.
"We have set the date, and it might be a little bit later," he said. "However, I believe that the lines of communication are open... We did not break down the agreement."
The rabbinical court, he said, "is making a very thorough and broad investigation. They will not leave one stone unturned."
But whatever the court's ultimate conclusions about Rabbi Fischer, it will not impact the practice of metzitzah b'peh in the haredi community, said Niederman.
"We are convinced that it's not dangerous," he said.
In metzitzah b'peh, a mohel orally sucks blood from the site of the genital cut he makes during the circumcision procedure. Not all haredi groups mandate the practice, but several haredi sects insist that it is required by Jewish law.
Rabbi David Zwiebel, executive vice president of Agudath Israel of America, an Orthodox umbrella group, estimates that metzitzah b'peh is performed more than 2,000 times a year in New York City.
In his Open Letter, Frieden reviews seven cases of herpes that have occurred locally, including two this year that the letter discloses publicly for the first time. Health Department investigators have concluded all were transmitted by mohels performing metzitzah b'peh.
Frieden's warning against the procedure comes more than a year after a cluster of three neonatal herpes cases were attributed to Fischer, and, according to New York's Jewish Week, a full five years after two senior pediatricians at Long Island Jewish Medical Center, warned the city that metzitzah b'peh was putting the lives of Jewish infants at risk.
Frieden issued his statement in two parts: the Open Letter and a one-page fact sheet titled "Before the Bris: How to Protect Your Infant Against Herpes Virus Infection Caused by Metzitzah B'peh."
The fact sheet, which is included on the Health Department's Web site, www.nyc.gov/html/doh/html/std/std-bris.shtml, states that "circumcision has health benefits," but goes on to explain how herpes is contracted from mohels who employ metzitzah b'peh and encourages parents to "consider other options."
Zwiebel, of Agudath Israel, an organization that represents haredi interests, said he would have preferred the statement not be issued.
But at least "they have been true to their commitment that they would not regulate the procedure," he said of Health Department officials. "They haven't banned it and haven't required some sort of informed consent, which was an idea on the table at an earlier stage."
Zwiebel was concerned that the department's action could harm the haredi community's public image and serve as a "foundation on which other jurisdictions might choose to regulate the practice, or even New York City might do that at some future date."
Niederman stressed the huge number of metzitzah b'peh procedures performed with no apparent ill effects.
"There have been seven cases, allegedly over a span of 15 years," he said. "In Williamsburg alone we have close to 57,000 people. The overwhelming majority is very young, so you're talking about 120,000 brises of metzitzah b'peh. You tell me, is it safer to give a flu shot or to do metzitzah b'peh?"
Not all mohels agree.
Rabbi Yitzchok Adler, spiritual leader of Beth David Synagogue, a modern Orthodox congregation in West Hartford, who also performs many of the community's ritual circumcisions, notes, "It is the responsibility of a mohel to review every step of the procedure with the baby's parents so that they are aware of what the child is about to endure. Since 'metzitza' is intended to draw blood away from the site of the wound, and there are techniques other than oral suction which can accomplish the same goal, I see no imperative to insist on 'metzitza'."
What does Adler suggest for families who consider "metzitz" an important tradition?
"The father should consider performing the custom himself. Remember, the Torah commandment is for a father to circumcise his son. The mohel stands in for the father to do what the father cannot. If the father wants metzitza, the father can be shown how."
Ultimately, however, Adler is among what he calls "a growing chorus of rabbinic authorities who are discouraging metzitza."
"Just as medical science has shown us how to make milah safer with modern sterilization and innovative surgical instruments, similarly we should welcome the professional wisdom regarding the control of infection. A mohel who is modern in his technique is serving his community in a fashion that enhances the observance of the mitzvah. It is never a sin to play it safe."
Like Adler, Rabbi Moshe Tendler, a dean at Yeshiva University's rabbinic school and a professor of biology there, as well as an expert in Jewish medical ethics with a doctorate in microbiology, opposes metzitzah b'peh as halachically unnecessary and medically dangerous.
"I'm convinced that many children have been infected and not diagnosed, and years later they are in special education in the schools and no one knows why," Tendler said.
Dr. John Santelli, a pediatrician and chair of the department of population and family health at Columbia University's Mailman School of Public Health, said, "It's difficult when there's a potential clash between religious values and medical information, but it's really important that parents know, and for the commissioner to take the position that this is a dangerous practice."
"The commissioner is now throwing the ball back to the community and saying, 'How are you going to respond to this?'" Santelli said. "I hope we don't have another tragedy."
--Judie Jacobson also contributed to this story.